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Oral Pathology Heavy > Oral Precancerous Lesions > Flashcards

Oral Precancerous Lesions Flashcards

1
Q

85% of oral precancers are?

A

Leukoplakias

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2
Q

A simple definition of leukoplakia is?

A

Suspicious white patch

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3
Q

What are 4 factors in the development of leukoplakia?

A

Tobacco smoking, sanguinara, UV, microorganisms

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4
Q

Who typically gets leukoplakia?

A

Men over 40

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5
Q

Where do most leukoplakia occur?

A

Lip vermilion, buccal mucosa, gingiva

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6
Q

Is leukoplakia a microscopic diagnosis?

A

No just a clinical impression

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7
Q

Describe a mild/thin leukoplakia

A

Grey-white with sharply defined borders, soft, slightly elevated

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8
Q

Which variant of leukoplakia has the highest risk of malignancy?

A

Erythroleukoplakia, a white plaque with scattered red patches

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9
Q

Most leukoplakias exhibiting dysplasia or carcinoma are in what locations?

A

Tongue, lip vermilion, floor of mouth

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10
Q

Most cases of leukoplakias are what microscopically?

A

Benign hyperkeratosis

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11
Q

What percentage of leukoplakias become SCC? What percentage are malignant initially?

A

4 and 5% respectively

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12
Q

What percentage of dysplastic leukoplakias become malignant?

A

10-15%

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13
Q

Which gender has a higher risk of malignant transformation?

A

Female

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14
Q

How is malignant transformation typically predicted?

A

Histopathologic grading of dysplasia

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15
Q

What 3 markers indicate a possible evolution to cancer?

A

p16, p53, and ki-67

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16
Q

What does the term sublingual keratosis refer to?

A

Leukoplakias on the ventral surface of the tongue, floor of mouth, and lingual aspect of the mandibular alveolar mucosa. These have a high risk for dysplasia and carcinoma

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17
Q

A high risk form of leukoplakia with multiple white plaques and roughened surface projections is?

A

Proliferative verrucous leukoplakia

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18
Q

Most cases of proliferative verrucous leukoplakia occur in ?

A

Elderly women with no risk factors

19
Q

How does erythroplakia compare to leukoplakia in terms of frequency and risk of malignancy?

A

Less common but more likely to be malignant

20
Q

Erythroplakia presents as?

A

A red patch that cannot be classified as any other condition

21
Q

In the US, most cases of erythroplakia are seen in?

A

Elderly men

22
Q

Where are most cases of erythroplakia seen?

A

Floor of mouth, tongue, retromollar-tonsillar pillar, soft palate complex

23
Q

How do most cases of erythroplakia appear microscopically?

A

90% are malignant or dysplastic

24
Q

The epithelium in erythroplakia can be described as?

A

Non-keratinized and atrophic

25
Q

Reverse smoking is associated with?

A

Dysplasias and cancers of the palate

26
Q

The dysplasias of the palate seen in reverse smoking are called?

A

Nicotine palatinus

27
Q

What changes in the mucosa are seen with use of smokeless tobacco?

A

Rippled, faintly white mucosa

28
Q

How long does it take for smokeless tobacco keratosis to reverse?

A

6 weeks

29
Q

What type of smokeless tobacco carries the greatest risk of oral cancer?

A

Dry snuff

30
Q

Keratosis associated with betel chewing is strongly or weakly associated with dysplasia and SCC?

A

Strongly

31
Q

Where is betel quid used?

A

South Asia

32
Q

What are two consequences of betel quid use?

A

Submucous fibrosis and epithelial dysplasia/carcinoma

33
Q

Can betel quid without tobacco be carcinogenic?

A

Yes

34
Q

Submucous fibrosis typically affects who?

A

Young and middle aged adults

35
Q

The progressive mucosal stiffening in submucous fibrosis leads to?

A

Marblelike pallor that progresses to trismus

36
Q

What tissues are seen in sub mucous fibrosis?

A

Very dense collagenous fibrous connective tissue with chronic inflammation

37
Q

What epithelial changes are seen in dysplasia associated with betel chewing?

A

Sub epithelial vesicles in early lesions

Hyperkeratosis with marked atrophy in older lesions

38
Q

How much does oral sub mucous fibrosis increase the risk of getting oral cancer?

A

19x

39
Q

What is betel chewers’ mucosa

A

A benign change in which the mucosa becomes brown/red

40
Q

What is actinic cheilosis

A

A pre malignancy of the lower vermilion due to UV

41
Q

Who typically gets actinic cheiolosis

A

Fair skinned elderly men

42
Q

What are the first clinical signs of actinic cheilosis?

A

Atrophy of the lower lip vermilion with smooth surface and blotchy pale areas

43
Q

The epithelium in actinic cheilosis can be described as?

A

Atrophic with heavy keratin

Oral Pathology Heavy (7 decks)

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